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Emilio Tan v CA and american insurance However, on that same day, Eulogio died of cardio-respiratory
Violeta Lalican v Insular Life Assurance arrest secondary to electrocution. Violeta, Eulogio's widow filed
New Life Enterprise and sy v CA with the Insular Life a claim for payment of the full proceeds of
Manulife Philppines v Hermegilda the policy but the latter informed her that the claim could not be
Sun life of canada v Daisy Sibya granted since at the time of Eulogio's death, his policy has already
Insular Life Assurance v Paz Khu lapsed and he failed to reinstate the same. Violeta requested a
reconsideration of her claim but the same was also rejected.
Therefore, she filed a complaint for death claim benefits with the
EMILIO TAN vs. COURT OF APPEALS G.R. No. 48049, 29 June 1989 RTC alleging the unfair claim settlement practice of Insular Life
and its deliberate failure to act with reasonable promptness on
her insurance claim. The trial court rendered a decision in favour
FACTS: Tan Lee Siong, father of herein petitioners, applied for life of Insular Life and after the former denied her motion for
insurance in the amount of P80,000.00 with respondent company reconsideration, she directly elevated her case to the Supreme
Philippine American Life Insurance Company. Said application was Court via the petition for review on Certiorari.
approved and a corresponding policy was issued effective
November 5, 1973, with petitioners as the beneficiaries. On April Issue:
26, 1975, Tan Lee Siong died of hepatoma. Hence, petitioners filed Whether or not the policy of Eulogio was reinstated before his
with respondent company their claim for the proceeds of the life death.
insurance policy. However, the insurance company denied the
said claim and rescinded the policy by reason of the alleged
misrepresentation and concealment of material facts made by the Ruling:
deceased Tan Lee Siong in his application for insurance. The Petition lacks merit. RTC's decision has long acquired finality for
premiums paid on the policy were thereupon refunded. The Violeta failed to file a notice of appeal more than five months
petitioners contend that the respondent company no longer had after the decision was rendered. As to the substantial claim of
the right to rescind the contract of insurance as rescission must whether there is insurable interest, the Court says that the matter
allegedly be done during the lifetime of the insured within two of insurable interest is entirely irrelevant and the real point of
years and prior to the commencement of action. contention herein is whether Eulogio was able to reinstate the
lapsed insurance policy on his life before his death. The Court
ISSUE: Whether or not the insurance company has the right to rules in the negative, for the insurance policy is clear on the
rescind the contract of insurance despite the presence of an procedure of the reinstatement of the insurance contract, of
incontestability clause which Eulogio has failed to accomplish before his death. As
provided by the policy, insurance shall be deemed reinstated
HELD: upon the approval of
over-insurance and thus avert the perpetration of fraud. The On June 23, 1999, Felipe's policy lapsed due to non-payment of
public, as well as the insurer, is interested in preventing the the premium covering the period from June 22, 1999 to June 23,
situation in which a fire would be profitable to the insured. 2000
“Also, policy condition 15 was used. It stated: 15.. . . if any false
declaration be made or used in support thereof, . . . all benefits On September 7, 1999, Felipe applied for the reinstatement of his
under this Policy shall be forfeited . . .” policy and paid P25,020.00 as premium
As for condition number 27, the stipulation read:
27. Action or suit clause. — If a claim be made and rejected and On October 12, 1999, Insular Life advised Felipe that his
an action or suit be not commenced either in the Insurance application for reinstatement may only be considered if he agreed
Commission or any court of competent jurisdiction of notice of to certain conditions such as payment of additional premium and
such rejection, or in case of arbitration taking place as provided the cancellation of the riders pertaining to premium waiver and
herein, within twelve (12) months after due notice of the award accidental death benefits. Felipe agreed to these conditions[8]
made by the arbitrator or arbitrators or umpire, then the claim and on December 27, 1999 paid the agreed additional premium of
shall for all purposes be deemed to have been abandoned and P3,054.50
shall not thereafter be recoverable hereunder.
This is regarding Sy’s claim for one of the companies. Recovery On September 22, 2001, Felipe died
was filed in court by petitioners only on January 31, 1984, or after
more than one (1) year had elapsed from petitioners' receipt of On October 5, 2001, Paz Y. Khu, Felipe Y. Khu, Jr. .and Frederick Y.
the insurers' letter of denial on November 29, 1982. This made it Khu (collectively, Felipe's beneficiaries or respondents) filed with
void. Insular Life a claim for benefit under the reinstated policy. This
claim was denied.
_________________________________________________
Issues:
Manulife Philppines v Hermegilda
Insular Life countered that Felipe did not disclose the ailments
FACTS: •Manulife instituted a Complaint for Rescission of (viz., Type 2 Diabetes Mellitus, Diabetes Nephropathy and
Insurance Contracts against Ybañez and the BPI Family Savings Alcoholic Liver Cirrhosis with Ascites) that he already had prior to
Bank (BPI Family). ○It was alleged that the Insurance Policies his application for reinstatement of his insurance policy; and that
which Manulife issued in favor of Dr. Gumersindo Ybañez it would not have reinstated the insurance policy had Felipe
(insured), were void due to concealment or misrepresentation of disclosed the material information on his adverse health
material facts in the latter's applications for life insurance. ○For condition. It contended that when Felipe died, the policy was still
this reason, Manulife accordingly denied Hermenegilda's death contestable... whether Felipe's reinstated life insurance policy is
claims and refunded the premiums that the insured paid on the already incontestable at the time of his death.
subject insurance policies. •In her Answer, Hermenegilda
(beneficiary) countered that: ○Manulife's own insurance agent, Ruling:
Monteclaros assured that there would be no problem regarding
the application for the insurance policy. ○In fact, it was this Court adopts the interpretation favorable to the insured in
Monteclaros who filled up everything in the questionnaire, so that determining the date when the reinstatement was approved.
all that the insured needed to do was signed and it's done. ○It was
also Monteclaros who herself checked in advance all the boxes We deny the Petition.
that the insured was required to answer. ○Manulife accepted the
insured's application, and now that a claim for the benefits is Based on the foregoing, we find that the CA did not commit any
made, Manulife now says that the insured misrepresented and error in holding that the subject insurance policy be considered as
concealed his past illnesses. ➢In the form filled up by Dr. reinstated on June 22, 1999. This finding must be upheld not only
Lumapas, Manulife's company physician, the insured checked the because it accords with the evidence, but also because this is
column which says ''yes" to the question: Have you seen a doctor, favorable to the insured who was not responsible for causing the
or had treatment operation on hospital case during the last five ambiguity or obscurity in the insurance contract.
years? ○Hermenegilda asserts that Manulife ought to have noted
the fact that the insured was at that time already 65 years old, WHEREFORE, the Petition is DENIED. The assailed June 24, 2010
that he had a previous operation, and that his health was "below Decision and December 13, 2010 Resolution of the Court of
average. Appeals in CA-GR. CV No. 81730 are AFFIRMED.
HELD: No. Manulife failed to prove concealment on the part of that given the obscurity/ambiguity in the language of these two
the insured. The RTC correctly held that the medical records that documents, the construction/interpretation that favors the
might have established the insured’s purported insured's right to recover should be adopted; a... that the CA
misrepresentation/s or concealment/s was inadmissible for being erred in declaring that resort to the principles of statutory
hearsay, given the fact that Manulife failed to present the construction is still necessary to resolve that question given that
physician or any responsible official who could confirm or attest the Application for Reinstatement,... The court below is correct.
to the due execution and authenticity of the alleged medical Given the obscurity of the language, the construction favorable to
records. For failure of Manulife to prove intent to defraud on the the insured will be adopted by the courts.
part of the insured, it cannot validly sue for rescission of insurance
contracts.
Facts: